The sad truth about sadness | By Richard P. Holm, MD


Through my years of caring for people caught in the joy-starvation of depression, I have seen the devastation from that awful diagnosis involve not only those sad and melancholy, but greatly affect those around them. For those 18 to 45 years of age, depression is the number one cause for disability, resulting in an estimated 200-plus billion dollars of lost earnings per year. I have looked on with aghast when depression caused such helplessness that the patient chose to escape life with suicide. There are about 40,000 deaths per year to suicide, which accounts for about the same number of deaths to breast cancer. It is also sad that research to help those with depression receives one-hundredth the amount of funding for research that occurs for those with breast cancer. The theoretical causes for severe melancholy and despair include a genetic tendency, a learned process, a stressful environment, a sad situation, addiction, or even not enough sun; but science has not defined exactly why depression occurs. Most of us periodically have what is called “situational depression,” such as the appropriate sadness that follows severe loss or death, for example, but what is more typical of harmful depression is when there is no ‘situation,’ no reason for it to happen, no sad story to explain why one is filled with sadness. When the patient says, “there is no reason for it,” then the clinician knows there is a problem. The diagnosis is not always that easy. We suspect depression when people experience chronic pain, find it hard to concentrate, are without energy, have flares of temper, sleep too much or too little, have a loss of appetite or have over-eating binges, have unexplained crying spells, or become filled with anxiety for minimal reasons. Often people make things worse by covering-up depression with alcohol, sleeping pills, anti-anxiety medications, or substance abuse, and these all make the diagnosis even more difficult. Although two-thirds of the people with depression do not seek or receive help; when the one-third that do get help follow-through with treatment, 80% are better in four to six weeks. There is help and hope for those with this miserable condition, but people need to be open to the possibility of such a problem, (men are usually the worst deniers.) Treatment includes a half-hour of exercise or walking daily, often a minimal-side-effect, inexpensive, anti-depressant medicine, and someone to talk to. If you are possibly struggling with depression, please get help. At least do it for those around you.

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